Should I worry if I have bleeding after sex?
If you are experiencing this issue, you are not alone! It can range from a little spotting to a significant amount of bleeding. It is a fairly common issue and there are many possible reasons this could occur.
Whether your health care provider does any further testing will depend in part on your age, your own unique medical history and the description of your bleeding. In this article, I will try to broadly give you an idea of some of the different possible causes but you should always discuss with your own provider as there could be other causes not included here.
Let’s start with some of the more common possible causes for this type of bleeding. It can be normal for a woman to get a slight amount of bleeding around ovulation. She may also have bleeding as a side effect of hormonal medications such as the birth control pill or progesterone IUD. Bleeding can occur from physical trauma from the act of sex or use of sex toys. A woman can also have abnormal, non-cancerous growths on the cervix or uterus known as polyps or fibroids. These growths can be found by exam and/or with pelvic ultrasound. Lastly, a woman can have hormonal imbalances that can lead to irregular periods in addition to bleeding in between periods.
When a woman has ANY type of unexpected bleeding (bleeding after sex or just random bleeding in between periods), we want to rule out pregnancy. This is easy for you to do at home - just buy an over the counter pregnancy test. Most of them are as accurate as the urine tests that your provider will do in their office and will show a pregnancy as soon as 2 weeks after conception. If the test is positive, you need to call your doctor right away for an appointment since bleeding in early pregnancy can be a sign of a dangerous type of pregnancy known as an ectopic pregnancy.
If the pregnancy test is negative you can breathe a sigh of relief but there is still more to consider. Other, causes of bleeding after sex are vaginal or pelvic infections. These can be caused by sexually transmitted infections such as chlamydia and gonorrhea or by non-sexually transmitted infections such as yeast or bacterial vaginosis. You may have chlamydia or gonorrhea but not have any signs of infection (see my YouTube video on this subject: HERE). so it is important to get that checked out right away if you have been having sex without a condom. All of these infections are easy to treat with antibiotics if caught early.
In some cases, a doctor may feel it necessary to rule out the most serious causes of bleeding after sex. We all worry about cancer when we have physical symptoms outside of the norm. This is fortunately not usually the case but it should be considered. Cervical pre-cancer or cancer can be assessed by a combination of a pap smear and/or a procedure called a colposcopy. If your recent pap smear was normal, then this is much less likely but you should still see a gynecologist if the bleeding persists. Other types of cancers to consider are uterine, vaginal, and ovarian cancers. These latter ones are more common as women get older with her risk increasing every year over the age of 45. They can be further assessed with exams, biopsies and/or ultrasounds.
Most of these different conditions can be assessed at your health care provider’s office with a thorough medical history, a physical exam, some simple lab tests and perhaps a pelvic ultrasound. Remember that most of the time this issue is NOT due to a serious condition but there are always exceptions so be sure to see you health care provider if the problem persists!